Patient is New M2: Presents with Delirium Tremens, Withdrawal, Hyperactivity, Paranoia, Psychosis

1:35 p.m., August 20, 2017 

I’m really depressed right now. Not in like a serious way, but more in a melodramatic snap-out-of-it sense. I’m back at school. Sitting in a coffee shop. Hungover as hell. Sipping coffee. Reading Reddit. Pondering what will happen in tonight’s Twin Peaks episode. Thinking about writing. Writing a sentence then deleting it. Reading a paragraph of First Aid then quitting. Ruminating over my plan for the forthcoming year. Daydreaming of being back at Bonnaroo or on the beach or getting wasted all day in Chicago. Doing nothing.

One may wonder, why Soze, why are you sitting in a coffee shop mindlessly browsing the internet on the day before you start your second year of medical school when you should be at home snoozing and nursing that hangover of yours? I’ll answer for ya – In my joyful summer of hedonism, I was at home away from school for almost three months. Consequently, I completely neglected to pay my electric bill for my apartment in the summer. And what do ya know… I come back to get settled into school yesterday, and my electricity is turned off! Ain’t that funny.

The day is August 20th and it’s 80-some degrees outside. Meaning it’s like 90 degrees in my apartment. And I can’t turn the air conditioning on, because that requires electricity. I also can’t watch T.V., because that requires electricity. I’d love to go get groceries and stock up on food before classes start, but the fridge requires electricity. And I can’t even charge my computer or phone, because… well, you know. And the electric company can’t even come turn the electric on until tomorrow morning at the earliest. Classic.

So here I am, making the most of it. Actually making the most of it would be going to the bar, but I’m not in the mood for solo Sunday day drinking in bars filled with 20 year old frat guys and sorority girls. Why don’t we have a good grad-student bar here? Not one place to go and sip a beer in peace without Top-40 radio blaring and shoes sticking to the floor covered with last night’s spilled beverages. Look, I still enjoy grabbing a case of beer for the small price of an Andrew Jackson and drinking at a college house until the sun starts to set and I come to the realization that I just don’t quite have the stamina that I did at 20. I’m not old. I’m just… I don’t know.

I do have friends here, but it ain’t the same. They’re a good time, but it’s superficial. Brothers of the same struggle I suppose. I study alone. See them in the mandatory class activities. And go drinking with them after the exams. That’s it. We went out last night. I went over a friends place with a some Bud heavies to pregame. Before we left, his roommate said he’d catch up with us later. He didn’t. Apparently, he stayed in all day and night to study First Aid. On the last Saturday before our second year of medical school starts. When boards are like 9 months away. Fuck that guy. I’m neurotic. So when I hear that someone is studying more than me, my brain does backflips. Like Patrick Bateman in American Psycho when his colleague has a better business card than him. You’re studying more than me? I’m plotting your death. I compare myself far too much. Sometimes I need to take my own advice – you know, when I wrote about NOT comparing yourself to others. I chugged some more beer to calm down my brain synapses that were bursting with activity.

At the bar, someone bought a round of shots for like 6 people. That started a cascade of shot-buying. Each person who was gifted with a shot initially felt the need to buy a round for the rest of the people. I don’t know why that happens, but when it does, it usually guarantees that I’ll get KO’d before the final round. So I got super drunk and cabbed home around 1.

Entering med school immediately after my first year of college means I’m one of the younger guys in my class. The guys I’m friends with enjoy the same pleasures as me, but there’s a difference. If I say I’m going to hang out with a few of my undergrad friends (don’t worry, they’re all seniors and such), they all give me an “oh… that’s cool..” response coupled with an expression that says, we’re too old for that. As if there’s an age-limit to day drinking. As if you’re supposed to cut off every single friend under the age of 23 after graduating from college. As if you have to resign to a life of 10 p.m. bedtimes, hunting for a wife, playing 18 on Sunday morning instead of being viciously hungover, accumulating fat around the abdomen, drinking exclusively craft beers, and chatting about politics and stocks every time an opportunity arises. As if there’s a magical day when you hang up your lucky drinking shoes and put on your 40 year-old man work boots without savoring the time in between. As if there’s an age limit to having fun. That ain’t me.


 

5:48 p.m., August 20, 2017

I thought this day would never come. Towards the end of my first year of medical school, I was becoming exhausted with studying every day and missing out on many social events and drinking opportunities. Luckily, we were blessed with nearly three months of summer vacation. Light at the end of the tunnel. But the light faded and the tunnel collapsed. Or rather, the light at the end of the tunnel was very brief, like ten minutes of sunshine after a rainstorm before the dark clouds blocked out our star. Instilling false hope before I entered yet another longer tunnel with no light in sight. I miss it already. I miss being home. I miss my friends and my girl.

But today, I have nothing else to do aside from thinking about how badly I wish I could go back to June and do the summer over again. That glorious summer. Back in the spring, I was going to apply for a 9 week research internship at a local hospital. I asked a professor I liked for a letter of recommendation. He told me no. Said he didn’t know me well enough. He also said that he wouldn’t write it because committing to a 9-5 job with a pittance stipend for the entire summer is a horrible idea. Thank god for that guy.

Because last night while talking to a few people who did do similar research internships, they seemed rather sedated when the rest of us shared stories of our wild, relaxing three months of vacation. One guy said, “yeah I only really got two weeks of summer, but they were fun”. Jesus Christ man. Two weeks? You know we have an entire year to look forward to with board examinations at the end? You know we start clinical rotations shortly after? You know this was the last the last summer of your life to live completely worry free and indulge in whatever vice or sloth-like behavior you wish without having to worry about exams, work, Q4 call? I’m no shaman of wisdom, I’m pretty stupid actually, but I can say with a high degree of certainty that when one embarks on a long, arduous, stressful career path, it is vital to the soul that they enjoy life while they can. Whether that means drinking every night, reading three novels a week, painting pictures, hiking our beautiful country’s wilderness, or whatever the hell you love in life -this summer was the time to do it.

Be right back. The bar is calling my name.


 

2:50 a.m. August 21, 2017

With a twinkle of nostalgia in my eye, I can happily say I got drunk all summer and hung out with my friends. There were four of us. I mean, we had plenty of other friends, but the four of us were nearly inseparable for a couple years. They were the first people you call when you get out of class on Friday ready to get the weekend going. I have more memories (which shouldn’t be shared) with those guys than I do with anyone in the world. Yet, we can sit on barstools, years removed from trying our luck with fake ID’s from Guangzhou, and drink our beers with the comfort of knowing we’ve made it (or at least we’re in the process of it). Two engineers, one law student, and yours truly. We didn’t waste away in the library or attend every class or stay inside every time we had a presentation to give in the morning. We were slaves to the siren allure of youthful joys, late nights, sticky bar floors, $5 32-ounce domestic beers, shots that we couldn’t afford, and serving each other as wingmen in our debaucherous expeditions. We grew up in those bars.

Enough of my nostalgia.

The summer began as I walked out of my final exam to complete my M1 year. I went home and opened a bottle of Budweiser. I toasted to the ghosts of the thousands of hours I had spent studying in this apartment by myself over the past year. To the guy who moved into this apartment alone on very short notice, started classes and became consumed by the confusion and anxiety of not knowing how to navigate this new world of medicine. To the guy who many times stayed up just one more hour than his weary eyes thought they could allow to pack some more information into a brain that was in dire need of a few extra gigabytes of storage. To the guy who can look back on a year and say, I’m proud of myself.

Well that guy also kinda sucks because after that final exam, he went out, got a little too drunk, and woke up with mud all over his jeans, scraped up arms, and a poison ivy rash that spread to sacred areas of the body. At least I know that poison ivy is a Type IV Hypersensitivity reaction. Yay med school. Still waiting for the part where they teach us how to cure common ailments, like hangovers and colds.

Solid year. Learned a bunch. Ended up with poison ivy on my dick. Poetic. You win some, you lose some. Two weeks later, I went to Bonnaroo and the aforementioned mantra rang true again as I had my new iPhone stolen in the midst of a drunken slumber. Nevertheless, I spent a blissful weekend drinking beers from the crack of dawn until the end of the night, seeing talented live musicians perform daily, while adding more hilarious stories to my life’s mental memoir with friends new and old. And the entire time, the thought of medical school didn’t cross my mind for a single second.

Ain’t that beautiful?

That set the tone for the summer. Countless nights out on the towns of my youth. Friends from home. Friends from college. Friends that I met ten minutes prior while ordering my drink. Friends that I became friends with only because we both went out to the same bars every week. And in the mornings, I’d lie on the couch, waste away and nurse my hangover while watching all the movies I didn’t have time to watch during school. Until the next night started. On off nights I’d curl up in bed with my girl and make up for all the lost time before peacefully dozing away in her rosy cloud of a bed. It’s time for bed.


 

10:16 p.m. August 24, 2017

I’m going to finish this post tonight.

First week blues have been hitting me hard. Kind of like a Blue Monday (most depressing day of the year). Except it’s stretched into a week. And it’s not fun like the New Order song with the 80’s dance club ecstasy aesthetic and bouncy synthesizers. Not like a cool aqua blue or even a periwinkle blue. More like a very deep navy blue. That’s how this week feels. I haven’t had much time to write because I’m still trying to transition from drink every day to study every day mode. It sucks. Coffee. Lecture. Anki cards. Repeat for however many hours I feel like going until I find something to distract myself with. Like spending two hours reading through Twin Peaks theories on Reddit. I’ll get the hang of it again, but it hasn’t happened this week. I had the bizarre idea that I’d transition back into the swing of school refreshed and energized and hungry to succeed like a med student reincarnation of Lawrence Taylor with an 8-ball in the locker room. However, my transition back to studying was about as smooth as a shot of Everclear.

After getting pretty drunk Sunday night before my previous entry, I fell asleep, woke up at noon, and didn’t do a gotdamn thing all day. Didn’t watch a single lecture. Didn’t go to the gym. Didn’t write. Nothing. At least my electricity turned back on and I have air conditioning and the ability to charge my laptop and phone without hanging out at a coffee shop all day like I’m Barney Gumble at Moe’s Tavern.

Since I wasted Monday completely, I got behind. I can study from 8 a.m. to midnight if I feel like it. I really can. But one thing I cannot do is spend that entire time learning new information. For each day, my brain has a saturation point for the amount of new material I can process. I can review, practice, quiz myself, make higher order connections between concepts, and all that shit for longer than any human being should, but I simply can’t bring myself to spend an entire day and night learning fresh, new material. So I’m behind. Let’s reword that: I’m so behind. And I’ve called it quits for the night. The weekend is almost here. I won’t be studying or getting caught up. I’ll be getting drunk. Because we don’t have any exams for a few weeks, so why not. In fact, I’m calling it quits on the week right here, on Thursday night. I’m not worried about it – I know what I have to do next week. But for now, I’m on my second full serving of Bulleit bourbon and I’m feeling better than I’ve felt since Sunday night.

I’m periodically switching over from writing this to my latest new hobby – making mixes on GarageBand. I can put together a decent beat if I may say so myself. All I need is a drum machine, a quality synthesizer, and Logic or Ableton and I’ll be set. I should just take out more loans. Put it on my tab. If anyone wants to get me a birthday present, a TeenageEngineering OP1 would be cool. Thanks. For now, I’m working on a dance track that samples Goljan Audio lectures. I’m a nerd, I know.


 

1:36 a.m., August 31, 2017

Sorry, I was summoned to the bars on that Thursday. Seems that I wasn’t the only one who didn’t hit the ground running on the first week.

It’s technically Thursday morning, but in my book it’s still Wednesday night. It’s been a very productive day. I woke up early, hammered through lectures, made my Anki cards. Made a nutritious dinner of chicken, rice and broccoli. I’m caught up. Life is good.

This year, my focused have shifted away from memorizing useless minutiae on a lecturers powerpoint slides in hopes of getting 2 extra questions right on the pass/fail exam towards spending more time trying to learn the material in depth with a focus on high yield concepts that will appear on the boards. Every time I watch a lecture, I pause often, and search my First Aid pdf for the topic or keyword, reading the relevant sections and piecing together information that I’ll need to know when crunch time comes. For pathology lectures, I’ll watch the corresponding Pathoma videos on 1.5x speed before and after, which I started doing towards the tail end of M1 with great results. Preview with Pathoma/First Aid -> learn topic in depth -> review key points with Pathoma/First Aid. More people should do this.

Anyways, I haven’t had much time to write because I’ve been trying to get my feet on the ground here in M2, developing a solid study, workout, and sleep routine. I’ll be back to writing regularly now that I’m all caught up.

It has definitely been a productive day, but the last few hours have taken an unexpected turn into the depths of everybody’s favorite phobia. Outside of my apartment, I noticed a few spiders dangling from the overlying outdoor rooftop. I examined the arachnid creatures, went inside, and did a quick google search in hopes to identify my new neighbors. That turned into reading spider databases on the internet for a solid hour. Which then redirected my thoughts towards the possibility that some of these spiders were not merely neighbors, but perhaps roommates too. Gosh, I get lonely in here sometimes. How comforting.

After examining a few different areas in my apartment, I went to plug my phone charger into an outlet in the corner of my living room, right by the edge of my couch where I like to lie my head and take naps or sift through the internet when I should be studying. When my hand neared the outlet, I felt the unsettling sensation of fishing line stimulating the ol’ dorsal column spinal tract. I quickly jerked my hand back, removed the webbing, and turned the flashlight on on my phone for closer examination. I’m no entomologist, but it was definitely a spider web. Not the typical Halloween orb-web appearance nor the typical “dust bunny” look of a typical cobweb. Directly beneath my couch at the lower base, there was a tangle of three-dimensional, irregular webbing. Extending outwards, from the surface of the couch, to the lower wall by the electrical outlet, to the floor – there were longer, tougher fibers. I redirected my Wednesday evening research project towards identifying the type of spider by its web. It was a tangle-web spider. The most notorious of tangle web spiders are none other than the most infamous man-eater there is… The Black Widow.

I read more. Habitat. Web design. Lifestyle. Behaviors. And so on. According to many online spider databases, black widows like to make their tangle webs low to the ground,  in dark spaces, in warm climates, secluded from human activity, often under stones, below firewood piles, in barns, sheds, dark corners, garages, under furniturein basements. Now one may say, woah there buddy, they like the be secluded from human activity, you’re in your apartment every day! Right you are my friend. BUT, one must remember, I was at home, leaving my apartment unoccupied all summer. It was dark, undisturbed, and very warm of course considering I didn’t pay my electric. Pretty much the perfect environment for the little bugger to set up shop. At this point, my heart was racing and paranoia quickly seeped its way through my brain. I’m a hypochondriac as it is, so you know I have a proclivity to think the worst. I then Googled images of black widow webs. Sure enough, their webs looked identical to the one that lay beneath my couch in that dark secluded corner.

What the fuck do I do. Do I clear out the web and risk pissing off the venomous creature? No, no, no… A simple broom won’t do. Tomorrow I’m going to the gun store and buying a 12 gauge. But what if I miss. I will search the dark web until I can find a flame thrower and few grenades. Fuck spiders. For the past three hours, I suddenly feel like every brush of wind on the back of my neck is an eight-legged evolutionary mistake, an abomination to god’s animal kingdom, a miniature xenomorph extraterrestrial freak that came to our planet on a comet, a big white-head pimple right on the nose of our beautiful mother earth. I can’t sleep. It’s nearly 3 in the morning. Might just turn the gas on the stove, light a candle, grab my guitar and computer, and say sayonara to what was once a home of peace and comfort.

And then I do a few more Google searches and realize that the harmless common house spider spins the exact same web, and I’ve been frantically searching the internet and sweeping my apartment for three hours over something as harmless as an ant when I need to be up early to study tomorrow.

This is med school. Goodbye.

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